2001 21st Annual Conference on Families and Health

	Saturday Session Abstracts Back to Conference on Families and Health Schedule Saturday, March 3 Seminars 15 - 20 1 - 2:30 pm S15: Ethical Dilemmas in MedicineThe Seventh Chair Julie Schirmer, MSW, Richard Herman, George Dreher, MD, Maine Medical Center Family Practice Residency, Portland, Me; Jeri Hepworth, PhD, Robert Cushman, MD, University of Connecticut; Alan Lorenz, MD, University of Rochester Theater, literature, and the arts are innovative and fun mediums to learn the art of medicine. During this seminar, learners will be invited to participate in a group therapy session with physician characters from famous plays to increase understanding of personal responses to ethical dilemmas in medicine. S16: Working With Suffering Lucy Candib, MD, Family Health Center, Worcester, Mass Clinicians today are likely to encounter patients who are survivors of inflicted atrocities. People fleeing horrendous circumstances bring persisting memories that produce symptoms even for the next generation. In this seminar, participants will be able to share their experiences of working with survivors and learn about witnessing, testimony, and ritual as approaches to patients with unimaginable pain. S17: Across the Great Divide? Working With Gender Role-related Conflicts in Office Practice Joseph Stenger, MD, University of Massachusetts The thorniest family problems in practice can involve gender role conflicts. This session addresses typical examples, such as coping with parenting after divorce, accepting responsibility for contraception, and dividing the work of parenting. Bring your recent cases to discuss and leave with a greater sense of competence. S18: Cultural CompetenceDeveloping a Curriculum That Works Catherine Bratton Vourkas, ACSW, Jose Lopez, MS, DCSW, St Vincent's Catholic Medical Center, Jamaica, NY Over the past 5 years, the faculty at St Vincent's Catholic Medical Center has been developing a curriculum in cultural competence that addresses the multiple levels of diversity that are present in working with today's ever-changing patient population. In this seminar, we will share our experiences, including our pitfalls and successes, in introducing this material and what we have learned along the way. We will provide a detailed description of our curriculum, guidelines, and techniques for introducing it to faculty and residents as well as the materials and tools most useful in teaching about culture, race, ethnicity, and gender. S19: Ethical Perspectives on Caring for ColleaguesImprovising a Healthy Balance Marcia Smith, PhD, Kim Salloway, MSW, Nancy Long, MD, Margaret Tryforos, MD, Brown University Family physicians sometimes care for employees, colleagues, residents, and their families, either by choice or necessity. Therapists and physicians view this differently. This seminar will be a dialogue among disciplines. Ethical principles will be reviewed, followed by case discussion. The impact on residencies will be addressed. S20: Pragmatic Family TherapyStrategies and Models That Fit Family Physicians Shae Graham Kosch, PhD, Karen Hall, MD, Mary Ann Burg, MSW, PhD, David Feller, MD, University of Florida Anxiety disorders, depressive disorders, and certain child behavioral disorders are among the most frequently encountered conditions in a family physician's practice. Using the healing power of families to assist patients is increasingly seen as passe by some sectors of the health system, although its efficacy has been demonstrated for many conditions. This presentation will present several effective strategies to increase resident comfort and skill in the what-when-how of an effective biopsychosocial approach. Lecture-Discussions 7 - 9 1 - 2:30 pm L7A: Boundary IssuesWork, Life, Family, Patients:Where Do We Draw the Line? Glenn Griffin, MD, MSc, Melissa Arthur, MSW, MA, State University of New York, Syracuse Where lies the boundary that separates our work from our personal lives, our families, and our friends? What defines the boundary that distinguishes us from our patients/clients? On what basic principles can we base our decisions in this danger zone fraught with misconceptions, misperceptions, miscommunications, and booby traps, many of which we unwittingly set for ourselves? L7B: Resident Support Stacey Garber, MD, Steven Brown, MA, LPC, Judy Richter, RN, PhD, Terri Olivas-Singer, MA LPC, North Colorado Family Medicine, Greeley For residents, the combination of long hours, transi-tion in professional and personal roles, and high expectations can lead to physical and emotional exhaustion. It is our responsibility as colleagues, educators, and employers to provide sufficient support to residents. Discussion will revolve around creative forms that this support can take. L8A: A Different Drummer: Gender Identity Disorders in Primary CareTuning in and Getting Trained Barbara Holstein, MEd, MA, University Medical Center, Lafayette, NY This jam-packed lecture-discussion challenges your assumptions about gender identity disorders, offers guidelines for hormonal and surgical sex reassignment, and requires that you role-play talking about transex-uality. Roles for both physicians and behaviorists in the treatment of this complex, biopsychosexual condition will be explored. L8B: Sex in Senior CityHelping Health Care Providers Address the Sexual Functioning of Senior Patients Mary Talen, PhD, Gordon Walbroehl, MD, Wright State University; Natalie Edmonds, Cindy Weisbart, MA, School of Professional Psychology, Dayton, Ohio While it is expected in clinical practice to address sexual activity with younger patients, discussing sexual functioning with senior patients is virtually ignored. Based on survey research, the knowledge, skills, and attitudes of patients and providers about sexuality and aging will be presented. L9A: The Home Visit in Family Practice Residency Training Beth Wernham, LSW, Lehigh Valley Family Health Center, Allentown, Pa Family practice residents are required by the Residency Review Committee to do home visits. Residents making home visits can meet health care needs not evident in office visits, and learn how the home environment affects physical and emotional health. Techniques for developing and implementing a successful program will be presented. L9B: Home Visit Chart RoundsA Tool for Teaching Residents the Resources of Family, Community, and Culture F. Alexander Blount, EdD, Warren Ferguson, MD, Valerie Pietrzyk Early, MD, University of Massachusetts Family physicians in urban underserved settings are challenged to understand the sociocultural experience from which their patients present. Home Visit Chart Rounds is a teaching tool for bringing residents into these home and community environments. Participants will learn this tool through presentation, a video of the process, and discussion. PEER Session D 1 - 2:30 pm PD1: Preference of Family Members to Have the Same Physician Appleton Mason, MD, Albany Family Practice, Albany, NY This ongoing project will determine patient preference for one physician to provide care for the whole family. Initial data shows an incongruity between patient preference and realization in actual practice. Further exploration will include family interviews to understand the patient belief systems. PD2: E-mail Your Family Doctor: Patient Preferences in a Family Practice Office Joyce Ildesa, University of Arizona Electronic mail has great potential as a convenient means of communication between physicians and their patients. It possesses distinct advantages, but concerns exist regarding its effectiveness in a clinical practice. This survey evaluates patients' interest in implementing e-mail to communicate with their medical providers in a family practice university-based health center. Survey results will be presented. PD3: Family Practice Residents' Views on Cultural Competency Training in Medical Education Kathryn Fraser, PhD, Halifax Medical Center, Daytona Beach, Fla Residents completed a survey on cultural competency training in their medical education. Females, first-year residents, minorities, and foreign-born residents had more favorable attitudes toward such training. Residents expressed approval of the general idea of cultural com-petency training, but were less in favor of using specific teaching and precepting opportunities for this training. PD4: New Information on Managing Dysmenorrhea Julia Graves, Charlton Methodist Hospital, Dallas A cross-sectional survey of menstruating women was used to see if there is a preference for pads over tampons among women with dysmenorrhea as compared to a con-trol group without dysmenorrhea. It showed that dysmenorrhea ranges from annoying to debilitating. Physicians often recommend NSAIDS, but anecdotal evidence sug-gests using pads instead of tampons may also reduce pain. These cross-sectional survey results may expand the in-formation physicians offer patients with dysmenorrhea. Seminars 21 23 2:45 4:15 pm S21: Facilitating Balance in the Personal and Professional Lives of Physicians: Dancing a West Texas Waltz Loren Bryant, PhD, Jennifer Culver, MD, Ronald Cook, DO, Jane Counts, PhD, Alice Ramsey, MD, Jennifer Seger, MD, Eric Babb, DO, Texas Tech University Using a metaphor of country western dance, this pre-sentation will reflect on successful balance in the personal and professional lives of physicians. Through dialogue com-paring the complexities of medical life with the experience of dancing, participants will process new thoughts about achieving balance in both their personal and professional lives while learning to dance the Texas Two Step. S22: The Talking CureCollaborative Conversations for Cross-cultural Solutions Jose Bayona, MD, MPH, Thelma Jean Goodrich, PhD, University of Texas, Houston Close collaboration between medical and mental health providers offers many benefits, but presents the challenges expected whenever two cultures come together. This sem-inar presents the experience of introducing family therapy interns into three established medical practices. By video, the interns and physicians describe problems and solutions and illustrate through cases. S23: Testimonios The Use of Narratives in Clinical Practice and Community Health Empowerment Eliana Korin, DiplPsic, Mary Frances Duggan, MD, Montefiore Medical Center, Bronx, NY The medical encounter provides a unique opportunity to honor patient's life stories and thereby promote healing and empowerment. Applying concepts based on Arthur Frank and Paulo Freire, this seminar will examine patient's storytelling or testimonies as an instrument in medical practice and community health education. Video-tapes of individual and group sessions will illustrate this particular use of storytelling. Workshops 4 8 2:45 5:15 pm W4: Word Jazz The Poetry of Our Experience Timothy Pollard, MD, Deborah Taylor, PhD, Central Maine Medical Family Practice, Lewiston, Me Poetry is verbal jazz. We will examine poetry created in response to the beauty and pain of caring for others and ourselves. Participants are encouraged to bring favorite pieces to share. Original works develop our improvisational skills, and the classics can broaden our perspective; both are welcome. Participants will create a piece of group poetry. We will exercise our connection to the creative side of our professions. W5: Gifts, Wounds, and ForgivenessKeys for Orchestrating Healing Rhythms in Families Marian Stuart, PhD, UMDNJ-Robert Wood Johnson Medical School Patterns of early family relationships, unresolved conflicts, and wounds continue to affect patients' health and sense of well-being. This experiential workshop will explore the profound differences between gifts and entitlements, reflect on the effect of wounds we have received or inflict-ed, and discuss how to overcome impediments to achieving forgiveness. W6: CollageA Tool for Self-expression, Healing, and Growth for Health Professionals, Patients, and Families Lucille Lomas Marchand, MD, Madison Family Practice Residency, Madison, Wis Collage is an art form that can assist us in speaking to our spirits in times of chaos or challenge. This workshop includes a centering, use of collage, mellow jazz in the background, and your chance to play, create, and share. Beginner minds encouraged. Bring magazines and scissors. W7: Developing a Spirituality and Medicine Curriculum in the Family Practice ResidencyPractical Issues in Design and Implementation Gowri Anandarajah, MD, Kim Salloway, MSW, Maureen Mitchell, DMin, Richard Long, MD, Ilene Klein, MD, Brown University This workshop will provide participants with specific resources and ideas needed to design and implement a spirituality and medicine component within their residency curriculum. Presenters will provide an overview of the sub-ject, including suggestions for core content areas, key issues in implementation, and a multidisciplinary, culturally sensitive approach to teaching. Participants will actively participate in small-group sessions aimed at developing creative and practical methods to teach, implement, and evaluate some of the core content areas within their own residency. W8: When Personality's a Problem Stacey Garber, MD, Steven Brown, MA, LPC, Terri Olivas-Singer, MA, LPC, Mark Wallace, MD, MPH, North Colorado Family Medicine, Greeley The importance of feedback is well accepted in resi-dency education. Presentations have focused on how to give effective feedback, but in some cases, one is forced to give input on what seems to be a personality trait. This session will provide participants with specific tools to approach this uncomfortable situation. Lecture-Discussions 10 11 2:45 5:45 pm Extended Sessions: Lecture-discussions combine didactic presentation with audience discussion; Lecture-discussions 10 and 11 will each offer four sessions given consecutively in this 3 hour time slot. L10A: A New Twist on the Case-based Conference to Teach Family and Biopsychosocial Issues Alan Wolkenstein, MSW, CICSW, Jeffrey Stearns, MD, Jean Slane, MD, University of Wisconsin The St Luke's Family Practice Residency has used an ambulatory case-based report to teach family and biopsychosocial aspects of patient care. A long-standing challenge has been a covert tendency for the discussion to revert to the biomedical issues of the case. This lecture-discussion will review our experience with the case-based format and the results of using a facilitator/observer to maintain the discussion focus on family and biopsychosocial issues. L10B: Drama School for Residents? Longitudinal Family Conference Role-play Akira Matsushita, Kawasaki Medical School Hospital, Okayama, Japan A new paradigm can be learned more easily by residents if the learning is enjoyable. Family conference role-plays have been conducted every other week for 6 months using difficult cases. Residents have learned family systems more easily and felt more comfortable in working with families after these situations. L10C: Teaching Family Systems to Third-year Family Practice ResidentsA Working Model Catalina Triana, MD, Dorothy Trevino, PhD, Robert Keith, PhD, University of Texas Medical Branch, Galveston We will present our block rotation in family systems medicine that teaches the knowledge, attitudes, and skills needed to assist family practice residents to function at Level 3 of Doherty and Baird's (1986)Levels of Physician Involvement. This innovative program integrates training with medical family therapy interns, measures knowledge and clinical skills via pre/posttest design, and teaches col-laboration skills and Level 3 skills using a live supervision model, allowing for instantaneous feedback on their family interventions. L10D: Talking With Family MembersA Model for Communication Skills Teaching in Clinical Settings Kathy Cole-Kelly, MS, MSW, MetroHealth Family Practice, Cleveland Attendees will participate in a skills workshop as if they were students/residents. Discussion about altering the workshop according to learner's level of family skills sophistication will follow. Six additional communications skills workshops containing family-oriented content will be described. Participants will discuss challenges for initiating similar ventures at their own settings. L11A: ImprovisationIntegrating Medical and Family Therapy Graduate Student Clinical Experiences Melton Strozier, PhD, Lee Bowen, PhD, Steve Livingston, PhD, Mercer University This session will present an innovative, interdisciplinary training model that integrates third-year medical students with family therapy graduate students in a family therapy clinic. Medical students learn the relevance of systems theory and individual and family development models as applied through assessment and clinical intervention with individuals and families. L11B: Using Medical Consultations for Collaborative Training Claudia Grauf-Grounds, PhD, Tina Schermer Sellers, MS, Seattle Pacific University Gather together students from family therapy, psychology, psychiatry, and family medicine and what do you get? A wonderful conundrum of perspectives. Students attend bimonthly, live supervision consultations to review the case addressing biopsychosocial spiritual concerns. View videotape of a case and the training models employed. L11C: Collaborative Care Strategies in the Recognition and Management of Medical Patients With Personality Disorders Jim Selby, PhD, University of North Carolina; Jerome Nymberg, MD, Nalle Clinic, Matthews, NC; Cindy Lyman, Carolina Psychological Services, Charlotte, NC Considerable attention has been focused on mental health issues in primary medical care. Much less attention has been devoted to the role of personality disorders in medical patients. This paper offers a framework for collaborative care of medical patients whose difficulties include a diagnosable personality disorder. L11D: Ecology in the Exam RoomPracticing and Teaching Collaborative Care William Gunn, PhD, Joni Staigers Haley, MS; Daniel Eubank, MD, Dartmouth Medical School This session will describe our 2-year experience with weekly pairing of behavioral health interns with second-year residents. Both groups of learners receive training in how to form collaborative relationships, contract for working together, and provide feedback. They then see all patients together in a given session. Videotape examples of these sessions will be shown. Results will be described from the added clinical value to patient care as well as the educational value described by the learners.